Ophthalmic surgical device for accessing tissue and for performing a capsulotomy

Abstract

A surgical device and procedure are provided for smoothly and easily accessing tissue to perform microsurgery, including a capsulotomy of a lens capsule of an eye. The device includes a handpiece with a tip for insertion into an incision in the cornea of the eye. A sliding element is disposed within the handpiece and a suction cup is mounted to the sliding element. The sliding element can be translated to move the suction cup into and out of the handpiece. A compression mechanism associated with the suction cup and the handpiece compresses the suction cup for deployment through the tip of the handpiece. The suction cup can expand inside the anterior chamber into a cutting position on the lens capsule. A cutting element mounted to the suction cup is used to cut a portion of the lens capsule and to remove the portion from the eye.

I claim: 
     
       1. A capsulotomy device for accessing a lens capsule through a cornea of an eye, the device comprising:
 a handpiece having a tip for insertion into an incision in the cornea of the eye; 
 a sliding element slidably disposed for translation within the handpiece; 
 a suction cup mounted to the handpiece; 
 a compression mechanism associated with the suction cup and the handpiece to compress the suction cup for deployment into an anterior chamber of the eye, the suction cup configured to expand inside the anterior chamber into a cutting position on the lens capsule; 
 a cutting element mounted to the suction cup for cutting a portion of the lens capsule, wherein the cutting element is an electrode, the electrode mounted around an underside of the suction cup and comprising a continuous element along which current can travel in two opposite directions for conducting current uniformly around a portion of the tissue of the lens capsule to be severed; and 
 one or more electrical elements for delivering current to an electrical lead connected to the electrode to heat the electrode for excising the portion of tissue, wherein the electrode comprises an upper ring that connects to the electrical lead and a lower ring that connects to the upper ring at two locations on opposite sides of the lower ring, and wherein the electrode is configured such that current travels from the upper ring to the lower ring via one of the locations and then travels around both sides of the lower ring to the location on an opposite of the lower ring to evenly distribute the current around the lower ring that is in contact with the lens capsule. 
 
     
     
       2. A capsulotomy device for accessing a lens capsule through a cornea of an eye, the device comprising:
 a handpiece having a tip for insertion into an incision in the cornea of the eye; 
 a sliding element slidably disposed for translation within the handpiece; 
 a suction cup mounted to the handpiece; 
 a compression mechanism associated with the suction cup and the handpiece to compress the suction cup for deployment into an anterior chamber of the eye, the suction cup configured to expand inside the anterior chamber into a cutting position on the lens capsule, the compression mechanism further comprising compression arms positioned on either side of the suction cup configured for movement inward toward each other to compress the suction cup and the cutting element mounted within the suction cup, wherein the compression arms are slidably attached to the sliding element for distal translation with the sliding element that presses the compression arms against internal walls of the handpiece to move the compression arms inward toward each other to compress the suction cup, and; 
 a cutting element mounted to the suction cup for cutting a portion of the lens capsule. 
 
     
     
       3. The device of  claim 2 , further comprising one or more suction elements connected to the suction cup for applying suction to the suction cup for securing the suction cup against the lens capsule. 
     
     
       4. The device of  claim 2 , wherein the suction cup further comprises a flared skirt extending from an edge of the suction cup for securing the suction cup against the lens capsule to form a vacuum seal. 
     
     
       5. The device of  claim 2 , further comprising a piston connected to an end of the sliding element opposite the suction cup and slidably associated with the handpiece for, responsive to an outside force, translating the sliding element distally to move the suction cup within the handpiece, out through the tip and to the lens capsule within the anterior chamber. 
     
     
       6. The device of  claim 2 , further comprising a knob connected via a slot in a housing of the handpiece to a side of the sliding element for, responsive to an outside force, translating the sliding element distally to move the suction cup within the handpiece, out through the tip for positioning against the lens capsule within the anterior chamber. 
     
     
       7. The device of  claim 6 , further comprising:
 an arm base disposed within the handpiece, slidably attached to the sliding element, and associated with the knob; 
 compression arms mounted to the arm base for, responsive to an outside force on the knob, translating distally and compressing the suction cup. 
 
     
     
       8. The device of  claim 2 , wherein the tip at a distal end of the handpiece comprises an opening for containing the compressed suction cup as it is translated into the tip for insertion of the tip into the incision. 
     
     
       9. A capsulotomy device for accessing a lens capsule through a cornea of an eye, the device comprising:
 a handpiece having a housing and a tip for insertion into an incision in the cornea of the eye; 
 a sliding element slidably disposed for translation within the handpiece; 
 a suction cup mounted to the handpiece; 
 a compression mechanism associated with the suction cup and the handpiece to compress the suction cup for deployment into an anterior chamber of the eye, the suction cup configured to expand inside the anterior chamber into a cutting position on the lens capsule, the compression mechanism further comprising compression arms positioned on either side of the suction cup configured for movement inward toward each other to compress the suction cup and the cutting element mounted within the suction cup, wherein the compression arms are attached to the housing of the handpieces; 
 a slidable member slidably attached to the housing for sliding distally over the compression arms for pressing the compression arms together to compress the suction cup; and 
 a cutting element mounted to the suction cup for cutting a portion of the lens capsule. 
 
     
     
       10. A method for accessing a lens capsule through a cornea of an eye with the capsulotomy device of  claim 9 , the method comprising:
 compressing the suction cup; 
 moving the tip of the handpiece through the incision in the cornea of the eye; 
 deploying the compressed suction cup out through the tip of the handpiece into the anterior chamber of the eye, the suction cup expanding inside the anterior chamber into the cutting position on the lens capsule; 
 cutting the portion of the lens capsule with the cutting element; and 
 removing the capsulotomy device from the eye. 
 
     
     
       11. The method of  claim 10 , wherein cutting the portion of the lens capsule further comprises:
 applying suction to the suction cup, the suction securing a flared skirt of the suction cup against the lens capsule and pulling tissue against the cutting element; and 
 cutting the tissue of the lens capsule pulled against the cutting element. 
 
     
     
       12. The method of  claim 10 , wherein cutting the portion of the lens capsule further comprises cutting out a portion of the tissue of the lens capsule using an electrode arranged around an underside of the suction cup. 
     
     
       13. The method of  claim 12 , wherein cutting out the portion of the tissue further comprises applying electrical current to the electrode via electrical leads that allow current to travel in two directions around a continuous element of the electrode that uniformly heats the portion of the tissue to sever the tissue. 
     
     
       14. The method of  claim 10 , wherein removing the capsulotomy device further comprises reducing the suction applied to the suction cup for releasing the suction cup from tissue of the lens capsule. 
     
     
       15. The method of  claim 10 , wherein removing the capsulotomy device further comprises withdrawing the suction cup with the portion of the excised lens capsule through the incision. 
     
     
       16. The method of  claim 10 , wherein removing the capsulotomy device further comprises:
 translating the sliding element proximally to move the suction cup away from the lens capsule within the anterior chamber, through the tip, and into the handpiece; and 
 withdrawing the tip of the capsulotomy device through the incision in the cornea and away from the eye. 
 
     
     
       17. The method of  claim 10 , wherein deploying the compressed suction cup further comprises translating the sliding element distally to move the suction cup within the handpiece, out through the tip and to the lens capsule within the anterior chamber, the suction cup expanding once it passes out of the tip of the handpiece. 
     
     
       18. The device of  claim 9 , further comprising one or more suction elements connected to the suction cup for applying suction to the suction cup for securing the suction cup against the lens capsule. 
     
     
       19. The device of  claim 9 , wherein the suction cup further comprises a flared skirt extending from an edge of the suction cup for securing the suction cup against the lens capsule to form a vacuum seal. 
     
     
       20. The device of  claim 9 , further comprising a piston connected to an end of the sliding element opposite the suction cup and slidably associated with the handpiece for, responsive to an outside force, translating the sliding element distally to move the suction cup within the handpiece, out through the tip and to the lens capsule within the anterior chamber. 
     
     
       21. The device of  claim 9 , further comprising a knob connected via a slot in a housing of the handpiece to a side of the sliding element for, responsive to an outside force, translating the sliding element distally to move the suction cup within the handpiece, out through the tip for positioning against the lens capsule within the anterior chamber. 
     
     
       22. A capsulotomy device for accessing a lens capsule through a cornea of an eye, the device comprising:
 a handpiece having a tip for insertion into an incision in the cornea of the eye; 
 a sliding element slidably disposed for translation within the handpiece; 
 a suction cup mounted to the handpiece; 
 a compression mechanism associated with the suction cup and the handpiece to compress the suction cup for deployment into an anterior chamber of the eye, the suction cup configured to expand inside the anterior chamber into a cutting position on the lens capsule, the compression mechanism comprising compression arms positioned on either side of the suction cup configured for movement inward toward each other to compress the suction cup; 
 a cutting element mounted to the suction cup for cutting a portion of the lens capsule; and 
 the compression mechanism further comprising two insertion fingers, wherein the two insertion fingers are disposed at the tip of the handpiece for maintaining the compressed suction cup in a flattened position as it is translated out of the tip and into the anterior chamber. 
 
     
     
       23. The device of  claim 22 , wherein the insertion fingers are sloped inward toward each other at a tip of the fingers, the tip being pressed together to form a wedge for sliding cleanly through the corneal incision, the lips configured to separate with pressure from the suction cup advancement out of the handpiece. 
     
     
       24. A device for accessing a second layer of tissue behind a first layer of tissue for performing microsurgery or therapeutic work, the device comprising:
 a handpiece having a tip for insertion through an incision in the first layer of tissue; 
 a sliding element slidably disposed for translation within the handpiece; 
 a foldable structure mounted to the handpiece; 
 compression arms positioned adjacent to the foldable structure and associated with the handpiece, the compression arms for compressing the foldable structure; 
 a manipulation mechanism for manipulating the compression arms to compress the foldable structure for deployment past the first layer of tissue, the foldable structure expanding into an operational position on the second layer of tissue, wherein the manipulation mechanism comprises an arm base slidably attached to the sliding element for distal translation with the sliding element thereby pressing the compression arms against internal walls of the handpiece to move the compression arms inward toward each other to compress the foldable structure; and 
 an operational element associated with the foldable structure for engaging in microsurgery or therapeutic work on the second layer of tissue. 
 
     
     
       25. The device of  claim 24 , wherein the operational element further comprises a cutting element mounted to the foldable structure for cutting a portion of the second layer of tissue. 
     
     
       26. A device for accessing a second layer of tissue behind a first layer of tissue for performing microsurgery or therapeutic work, the device comprising:
 a handpiece having a tip for insertion through an incision in the first layer of tissue; 
 a sliding element slidably disposed for translation within the handpiece; 
 a foldable structure mounted to the handpiece; 
 compression arms positioned adjacent to the foldable structure and associated with the handpiece, the compression arms for compressing the foldable structure; 
 a manipulation mechanism for manipulating the compression arms to compress the foldable structure for deployment past the first layer of tissue, the foldable structure expanding into an operational position on the second layer of tissue, wherein the manipulation mechanism comprises a slidable member slidably attached to the handpiece for sliding toward the foldable structure and over the compression arms positioned on either side of the foldable structure thereby pressing the compression arms together to compress the foldable structure; and 
 an operational element associated with the foldable structure for engaging in microsurgery or therapeutic work on the second layer of tissue. 
 
     
     
       27. The device of  claim 26 , wherein the operational element further comprises a cutting element mounted to the foldable structure for cutting a portion of the second layer of tissue.